Maternal health literacy and complementary medicine products: Information and recommendation sources used by pregnant and breastfeeding Australian women - results from a national online survey

Background: Pregnant and breastfeeding women commonly use complementary medicine products (CMPs) (dietary supplements/herbal medicines). Maternal health literacy highlights the importance of women seeking information to benefit their own and their children's health. However, little data on women's information-seeking behaviours regarding CMPs during pregnancy and lactation exists. Objectives: Identify pregnant and breastfeeding women's CMP information and recommendation sources; determine their most trusted sources; and describe the influence of these sources on CMP use decisions during pregnancy and lactation. Methods: This primary study utilised a national, online, cross-sectional survey conducted with pregnant and/or breastfeeding Australian women using CMPs. Purposeful and snowball recruitment were used. Screening questions ensured respondents were currently pregnant and/or breastfeeding, over 18, using CMPs, and living in Australia. Respondents reported on their use of CMP information and recommendation sources. Data were analysed using descriptive statistics and chi-square tests to compare differences between pregnant and breastfeeding cohorts. Findings: 810 women (354 pregnant, 456 breastfeeding) completed the survey; 93.3 % had adequate health literacy, 81.9 % were university educated, and 74.8 % had medium-high incomes. Almost all (99.6 %; n = 809) used dietary supplements; 57.3 % (n = 464) used herbal medicines. General practitioners (GPs) were the most trusted HCPs (27.0 %; n = 219). Significantly more breastfeeding women (p < 0.0001) trusted naturopaths, herbalists, GPs, pharmacists, child and family health nurses, and lactation consultants. Significantly more pregnant women (p < 0.0001) trusted midwives and obstetricians. Recommendations from HCPs positively influenced CMP use, while recommendations online or print media generally did not. Conclusions: Pregnant and breastfeeding women seek information on CMPs from various sources but trust HCPs the most. Maternity care clinicians should consider the diverse information and recommendation sources women access when discussing CMP use.